Veterans for Common Sense

Hunger for Dictatorship: War to export democracy may wreck our own

Students of history inevitably think in terms of periods: the New Deal, McCarthyism, “the Sixties” (1964-1973), the NEP, the purge trials—all have their dates. Weimar, whose cultural excesses made effective propaganda for the Nazis, now seems like the antechamber to Nazism, though surely no Weimar figures perceived their time that way as they were living it. We may pretend to know what lies ahead, feigning certainty to score polemical points, but we never do.

Nonetheless, there are foreshadowings well worth noting. The last weeks of 2004 saw several explicit warnings from the antiwar Right about the coming of an American fascism. Paul Craig Roberts in these pages wrote of the “brownshirting” of American conservatism—a word that might not have surprised had it come from Michael Moore or Michael Lerner. But from a Hoover Institution senior fellow, former assistant secretary of the Treasury in the Reagan administration, and one-time Wall Street Journal editor, it was striking.

Several weeks later, Justin Raimondo, editor of the popular Antiwar.com website, wrote a column headlined, “Today’s Conservatives are Fascists.” Pointing to the justification of torture by conservative legal theorists, widespread support for a militaristic foreign policy, and a retrospective backing of Japanese internment during World War II, Raimondo raised the prospect of “fascism with a democratic face.” His fellow libertarian, Mises Institute president Lew Rockwell, wrote a year-end piece called “The Reality of Red State Fascism,” which claimed that “the most significant socio-political shift in our time has gone almost completely unremarked, and even unnoticed. It is the dramatic shift of the red-state bourgeoisie from leave-us-alone libertarianism, manifested in the Congressional elections of 1994, to almost totalitarian statist nationalism. Whereas the conservative middle class once cheered the circumscribing of the federal government, it now celebrates power and adores the central state, particularly its military wing.”

I would argue that Rockwell—who makes the most systematic argument of the three—overstates the libertarian component of the 1994 Republican victory, which could just as readily be credited to heartland rejection of the ’60s cultural liberalism that came into office with the Clintons. And it is difficult to imagine any scenario, after 9/11, that would not lead to some expansion of federal power. The United States was suddenly at war, mobilizing to strike at a Taliban government on the other side of the world. The emergence of terrorism as the central security issue had to lead, at the very least, to increased domestic surveillance—of Muslim immigrants especially. War is the health of the state, as the libertarians helpfully remind us, but it doesn’t mean that war leads to fascism.

But Rockwell (and Roberts and Raimondo) is correct in drawing attention to a mood among some conservatives that is at least latently fascist. Rockwell describes a populist Right website that originally rallied for the impeachment of Bill Clinton as “hate-filled … advocating nuclear holocaust and mass bloodshed for more than a year now.” One of the biggest right-wing talk-radio hosts regularly calls for the mass destruction of Arab cities. Letters that come to this magazine from the pro-war Right leave no doubt that their writers would welcome the jailing of dissidents. And of course it’s not just us. When USA Today founder Al Neuharth wrote a column suggesting that American troops be brought home sooner rather than later, he was blown away by letters comparing him to Tokyo Rose and demanding that he be tried as a traitor. That mood, Rockwell notes, dwarfs anything that existed during the Cold War. “It celebrates the shedding of blood, and exhibits a maniacal love of the state. The new ideology of the red-state bourgeoisie seems to actually believe that the US is God marching on earth—not just godlike, but really serving as a proxy for God himself.”

The warnings from these three writers would have been significant even if they had not been complemented by what for me was the most striking straw in the wind. Earlier this month the New York Times published a profile of Fritz Stern, the now retired but still very active professor of history at Columbia University and one of my first and most significant mentors. I met Stern as an undergraduate in the spring of 1974. His lecture course on 20th-century Europe combined intellectual lucidity and passion in a way I had never imagined possible. It led me to graduate school, and if I later became diverted from academia into journalism, it was no fault of his. In grad school, I took his seminars and he sat on my orals and dissertation committee. As was likely the case for many of Stern’s students, I read sections of his books The Politics of Cultural Despair and The Failure of Illiberalism again and again in my early twenties, their phraseology becoming imbedded in my own consciousness.

Stern had emigrated from Germany as a child in 1938 and spent a career exploring how what may have been Europe’s most civilized country could have turned to barbarism. Central to his work was the notion that the readiness to abandon democracy has deep cultural roots in German soil and that many Europeans, not only Germans, yearned for the safeties and certainties of something like fascism well before the emergence of fascist parties. One could not come away from his classes without a sense of the fragility of democratic systems, a deep gratitude for their success in the Anglo-American world, and a wary belief that even here human nature and political circumstance could bring something else to the fore.

He is not a man of the Left. He would have been on the Right side of the spectrum of the Ivy League professoriat—seriously anticommunist, and an open and courageous opponent of university concessions to the “revolutionary students” of 1968. He might have described himself as a conservative social democrat, of the sort that might plausibly gravitate toward neoconservatism. An essay of his in Commentary in the mid-1970s drew my attention to the magazine for the first time.

But he did not go further in that direction, perhaps understanding something about the neocons that I missed at the time. One afternoon in the early 1980s, during a period when I was reading Commentary regularly and was beginning to write for it, he told me, clearly enjoying the pun, that my views had apparently “Kristolized.”

It is impossible to overstate my pleasure at being on the same side of the barricades with him today. That side is, of course, that of the antiwar movement; the side of a conservatism (or liberalism) that finds Bush’s policies reckless and absurd and the neoconservatives who inspire and implement them deluded and dangerous. In the past year, I had seen Stern’s letters to the editor in the Times (“Now the word ‘freedom’ has become a newly invoked justification for the occupation of a country that did not attack us, whose people have not greeted our soldiers as liberators. … The world knows that all manner of traditional rights associated with freedom are threatened in our own country. … The essential element of a democratic society—trust—has been weakened, as secrecy, mendacity and intimidation have become the hallmarks of this administration. … Now ‘freedom’ is being emptied of meaning and reduced to a slogan. But one doesn’t demean the concept without injuring the substance.”) In the profile of him in the Times, he sounds an alarm of the very phenomenon Roberts, Raimondo, and Rockwell are speaking about openly.

To an audience at the Leo Baeck Institute, on the occasion of receiving a prize from Germany’s foreign minister, Stern noted that Hitler had seen himself as “the instrument of providence” and fused his “racial dogma with Germanic Christianity.” This “pseudo–religious transfiguration of politics … largely ensured his success.” The Times’ Chris Hedges asked Stern about the parallels between Germany then and America now. He spoke of national mood—drawing on a lifetime of scholarship that saw fascism coming from below as much as imposed by elites above. “There was a longing in Europe for fascism before the name was ever invented… for a new authoritarianism with some kind of religious orientation and above all a greater communal belongingness. There are some similarities in the mood then and the mood now, although significant differences.”

This is characteristic Stern—measured and precise—but signals to me that the warning from the libertarians ought not be simply dismissed as rhetorical excess. I don’t think there are yet real fascists in the administration, but there is certainly now a constituency for them —hungry to bomb foreigners and smash those Americans who might object. And when there are constituencies, leaders may not be far behind. They could be propelled into power by a populace ever more frustrated that the imperialist war it has supported—generally for the most banal of patriotic reasons—cannot possibly end in victory. And so scapegoats are sought, and if we can’t bomb Arabs into submission, or the French, domestic critics of Bush will serve.

Stern points to the religious (and more explicitly Protestant) component in the rise of Nazism—but I don’t think the proto-fascist mood is strongest among the so-called Christian Right. The critical letters this magazine receives from self-identified evangelical Christians are almost always civil in tone; those from Christian Zionists may quote Scripture about the Israeli-Palestinian dispute in ways that are maddeningly nonrational and indisputably pre-Enlightenment—but these are not the letters foaming with a hatred for those with the presumption to oppose George W. Bush’s wars for freedom and democracy. The genuinely devout are perhaps less inclined to see the United States as “God marching on earth.”

Secondly, it is necessary to distinguish between a sudden proliferation of fascist tendencies and an imminent danger. There may be, among some neocons and some more populist right-wingers, unmistakable antidemocratic tendencies. But America hasn’t yet experienced organized street violence against dissenters or a state that is willing—in an unambiguous fashion—to jail its critics. The administration certainly has its far Right ideologues—the Washington Post’s recent profile of Alberto Gonzales, whose memos are literally written for him by Cheney aide David Addington, provides striking evidence. But the Bush administration still seems more embarrassed than proud of its most authoritarian aspects. Gonzales takes some pains to present himself as an opponent of torture; hypocrisy in this realm is perhaps preferable to open contempt for international law and the Bill of Rights.

And yet the very fact that the f-word can be seriously raised in an American context is evidence enough that we have moved into a new period. The invasion of Iraq has put the possibility of the end to American democracy on the table and has empowered groups on the Right that would acquiesce to and in some cases welcome the suppression of core American freedoms. That would be the titanic irony of course, the mother of them all—that a war initiated under the pretense of spreading democracy would lead to its destruction in one of its very birthplaces. But as historians know, history is full of ironies.

Homeless Veterans Wait Years for Aid

John Staresinich is a Purple Heart veteran who has slept in cracks in highway overpasses and abandoned cars, camped out in thin tents next to railroad tracks and fought off rats and bugs in Chinatown flophouses.

In December, he was diagnosed with severe combat-related post-traumatic stress disorder — 32 years after returning from Vietnam — and is now getting help from the federal Veterans Affairs in Chicago. He says it took more than a year of begging that agency.

“Soldiers from Iraq are going to come back with PTSD,” said Staresinich, 54. “I hope they treat them sooner than they did me.”

Mental health experts are predicting that as many as one-third of all Iraqi veterans will suffer from PTSD, a disabling disorder characterized by flashbacks and war nightmares. A similar percentage of Vietnam veterans have been diagnosed with the disorder — although it took decades for the government to recognize, treat and compensate those veterans.

Still, the VA officially maintains there’s no connection between military combat and homelessness. But people who work with veterans believe otherwise.

“Many people will tell you that military service is not a significant contributing factor to homelessness. But it clearly is a factor,” said Pete Dougherty, national director of the VA’s homeless veterans programs. “There are more veterans who have shown up in the ranks of the homeless than their average age cohort.”

There are 93,000 homeless Vietnam veterans, VA officials say. Illinois has the nation’s third-largest population of homeless vets — about 20,000.

Already about 100 soldiers from Iraq have turned up at homeless shelters around the country. And a study released last summer found that 17 percent of early returning Iraqi soldiers suffered from PTSD. Less than half of them had sought mental health care.

“I think PTSD is probably higher than it was in Vietnam because of the intensity of this conflict and the fact that we’re calling up a whole different demographic category of people for this conflict than we did in Vietnam,” said Dr. Ron Davidson, director of the mental health policy program at the University of Illinois at Chicago’s psychiatry department. Davidson directs counseling services for the Illinois Family Resource Network, the state’s outreach program for National Guard and Reserve family members.

Different demographics

Most soldiers in Vietnam were under 25, unmarried and had no children, Davidson said. In this war, most soldiers — especially those from the National Guard and Reserve units — are older, married and have children.

The Defense Department says it is evaluating soldiers before deployment, after they return home and three to six months later to determine whether they are at risk for the disorder.

That was certainly not the case when veterans returned from Vietnam in the 1960s and 1970s reporting constant fear, sleeplessness, anxiety and violent dreams. The military did not acknowledge their symptoms as a mental disability until 1980. By then, some veterans had been home for 15 years.

“The VA has to get out of the mentality of sitting and waiting for the patient to come to them,” Davidson said. “This is definitely a perverse part of the system.”

Homeless veterans are a difficult segment of society to serve. They are transient and, according to VA studies, about 45 percent are mentally ill and 70 percent have substance addictions.

The Chicago VA’s Homeless Coordinator refused an interview but her office released a list of programs that target homeless veterans, including an outreach effort that tries to get housing for those who are mentally ill.

But mentally disabled veterans, like Staresinich, say the VA’s bureaucracy — which demands reams of paperwork and months of haggling — leaves them waiting for disability decisions and appointments with doctors.

“The VA is oriented with procedure,” said John Rodriguez, a veterans representative with the Disabled American Veterans in Chicago who files disability claims for homeless veterans.

On Thursday, a Chicago Police officer and a social worker brought a homeless Vietnam veteran, a Purple Heart recipient, to Rodriguez. But when Rodriguez tried to get the VA to review the man’s case, he was told he couldn’t prove the veteran was homeless. Rodriguez had to get affidavits from the cop and the social worker before the VA would take the case.

Staresinich says he also ran into obstacles when he went to Hines VA hospital in December 2003, asking to “be committed.”

“I said I was suicidal. I begged them to help me. I wanted to see a doctor, a psychiatrist. I told them there’s something really wrong with my head,” said Staresinich, looking gaunt, his steel-blue eyes sunken like a skeleton. “They told me there was a wait for rehab.”

Staresinich knew he had to have proof of his military service. In his grimy pants pocket, he carried around a tattered copy of his DD-214 form — his discharge paper. It described another man, a war hero, a South Side 19-year-old who was drafted into the Army in June 1970 and returned home in February 1972 with a fistful of medals.

Now, just a whiff of garbage or a refrain from “Nights In White Satin” is all it takes for Staresinich to travel three decades back to the jungles of Vietnam, gunning down whatever moved in his scope.

He was a 20-year-old machine- gunner on an assault chopper, a soldier who threw around body parts, destroyed people’s homes and killed women and children.

“I’m doing this great thing for our country. My parents were proud of me. We were saving these people from communism,” he said.

After six months immersed in the bloodbath, Staresinich couldn’t sleep. In his nightmares, he was confronted with the faces of those he’d slain. That’s when another soldier offered him drugs and a drink. “Here, this will make you sleep,” he told Staresinich.

Thirty-two years, a marriage and several well-paying factory jobs later, Staresinich’s battle to forget has cost him everything — even his shiny war hero’s image.

“I think about Vietnam about a 100 times a day,” Staresinich said. “I hear songs on the radio that take me back. I see the war on TV. This stuff doesn’t go away. If anything it gets worse.”

Sleep aids: Beer, gin, drugs

To avoid recurring, violent nightmares, Staresinich has bought anti-anxiety drugs on the street. His sleep tonic also includes a case of beer or a fifth of gin.

In his dreams, the Viet Cong are always chasing him. In recent years, they have come the closest yet to killing him — having shot him twice and stabbed him once.

“In the dream, it seems real. It’s like I’ve never left,” he said. “I need medicine. I can’t put up with these dreams.”

About a month after his visit to Hines, Staresinich received a letter from the VA alerting him that he was eligible for health care. Staresinich says he wrote two letters back asking for help. He has several missing teeth and often his teeth ache so bad that he applies medicine directly to his gums.

“They never answered back once. I gave up,” Staresinich said.

He was so desperate for food and money that at one point he considered robbing a Brinks truck.

Staresinich said he became homeless about two years ago after his wife locked him out. She had put up with his decades of drinking binges and his three DUIs. They are now in divorce proceedings, he said. He has two daughters, 24 and 18.

After more than a year sleeping where he could, doing odd jobs –like delivering dead chickens –Staresinich, who receives food stamps, hooked up with a guy who gets Social Security and has a small apartment. Staresinich trades food stamps to sleep on the couch. But his buddy’s got a girlfriend now.

Another Vietnam veteran, Dave Marich, who runs a Southeast Side body shop, took Staresinich to a meeting of the Purple Heart veterans service organization. There Staresinich met Rodriguez, the veterans’ representative.

Staresinich was shocked that he would even qualify for disability.

“All those years I thought you had to be an amputee in order to be disabled,” Staresinich said. “No one told us differently.”

On Sept. 3, 2004, Rodriguez filed Staresinich’s disability claim for PTSD, unemployability and hearing loss. His file was marked with a dark pink tag to signify that the case involved a homeless veteran and needed to be expedited.

It took five months for a decision. On Jan. 7, the VA ruled that Staresinich is 100 percent disabled. Three weeks later, he received a $6,777 check retroactive to September when his claim was filed. He will receive $2,299 a month and plans to get his own apartment so his 18-year-old daughter can live with him.

But his veteran friends worry that it may be too late for Staresinich, who, flush with cash, now spends much of his time in neighborhood bars.

Another Vietnam veteran, Jerald Szemes, 57, of Michigan City, Ind., became homeless last year while fighting the VA for disability. Last May, Szemes started living in his Ford van. His bed companions were a homemade spear and a bayonet.

“In Vietnam, I slept with weapons,” Szemes said. “I never got out of the habit.”

As a Navy Seabee, he built look-out towers in the jungles: “We were like sitting ducks — 90 feet in the air with no place to go — taking sniper fire as we were going up there,” said Szemes, who tries to steady his shaky hands with a cigarette and a Diet Pepsi.

Szemes’ military trauma started before he left the United States. In 1969, during boot camp in Gulf Port, Miss., his unit was hit by Hurricane Camille. He spent two weeks picking up bloated bodies.

“We had to wear gas masks because the odor was so bad,” he said, his voice cracking.

Recurring nightmares

In Vietnam, he extricated body parts caught in razor wire after enemy soldiers tripped hidden bombs. He lost part of his hearing when a bomb hit his camp.

When Szemes returned home, he expected a homecoming.

“I was hoping to see a band playing John Philip Sousa, but that wasn’t the case,” Szemes said.

Instead Szemes and other veterans were told not to congregate and not to travel together in order to avoid protesters at the airport.

Health experts say being welcomed home is an important factor in a soldier’s recovery from painful war experiences.

Back home, Szemes, a construction worker, wasn’t able to keep a job. After Vietnam, he developed a fear of heights and couldn’t climb ladders. He couldn’t hear anyone unless they were speaking directly to him. By 1986, Szemes’ disorder was out of control. “I knew something was wrong. I was angered with people. I was depressed and paranoid and having nightmares,” he said.

Several of his recurring nightmares involve a 6-year-old hurricane victim whose body was so badly decomposed that her bones were sticking out. Another involves the body of a man he and others are freeing from tree limbs when it falls on them, raining down maggots and body parts.

On May 2, 1986, Szemes rigged up a rope and tried to hang himself, but his roommate discovered him and cut him down. Szemes’ mother called the VA hospital and asked to have him committed.

He spent three weeks in the psychiatric ward at Hines, but was released when he told the doctor he was all right, he said.

After he hit a man with a pipe three months later, he landed in the hospital again — this time for treatment for alcoholism.

“They should have told me that I had PTSD,” Szemes said angrily.

He was treated for several heart attacks from 1996 to 2002 at Hines and learned he has Agent-Orange-related diabetes. Nurses told him to file for disability pay.

On Feb. 4, 2003, Szemes filed for disability compensation for hearing loss, diabetes and PTSD. The head of Hines’ Post-traumatic Clinical Team diagnosed Szemes with combat-related PTSD. Because Szemes lives in Indiana, his claim was filed with the VA regional office in Indianapolis.

In August 2003, that office rated him 30 percent disabled. It denied his hearing loss and PTSD claim. Szemes appealed the decision. After months of waiting and trying to live on $310 in disability pay, Szemes was forced to move into his van. A Michigan City couple allowed him to park near their garage and run an extension chord to power a space heater.

Still a prisoner of trauma

Meanwhile, Szemes’ nightmares continued. In one, Szemes relives the death of a Vietnamese boy who was run over by an asphalt truck. The boy was trapped between two giant wheels, and he was burned by the asphalt. The boy died, but his screams still haunt Szemes.

Last October, Szemes’ counselor introduced him to Rodriguez, who had the case transferred to Chicago.

In December, Szemes was rated 100 percent disabled. In January, Szemes received a check for $37,000, retroactive to when he first filed his claim in 2003.

Szemes paid off credit cards that he lived on for two years and rented an efficiency apartment in Michigan City. He just celebrated two years of sobriety.

But Szemes says he is still a prisoner of his war traumas. Every time it rains, his mind goes back to the hurricane and the bodies. Loud noises make him uneasy. He takes 23 prescription pills a day. He attends PTSD group therapy each week, and he avoids people, spending much of his day sitting alone in his tiny apartment. He knows he’ll be dependent on the government for the rest of his life.

Abuses Endangered Veterans in Cancer Drug Experiments

ALBANY – Carl M. Steubing, a decorated Battle of the Bulge veteran whose experience of war made him a pacifist but also instilled in him a zest for living life at full tilt, took his diagnosis of gastroesophageal cancer in 2001 as a challenge.

With a thatch of white hair and a rich baritone voice, Mr. Steubing, at 78, was not ready to succumb to illness. A retired music educator and wedding photographer, he remained active as a church choir director, expert cook, painter, golfer and fisherman. He was married to a woman 24 years his junior, and they had seven children and three grandchildren between them.

Mr. Steubing jumped at the chance to participate in an experimental drug study at the Stratton Veterans Affairs Medical Center in Albany, believing it offered him the hope of surviving longer. The research coordinator, Paul H. Kornak, told Mr. Steubing that he was “just a perfect specimen,” with the body of a man half his age, according to Jayne Steubing, Mr. Steubing’s widow.

He was not, though. Because of a previous cancer and poor kidney function, Mr. Steubing was not even eligible to participate in the experiment, according to government documents. Mr. Kornak, however, brushed that obstacle aside. He altered Mr. Steubing’s medical records, according to prosecutors, and enrolled him in the study. He also posed as a doctor.

In 2001, Mr. Steubing endured about six periodic treatments with an aggressive three-drug chemotherapy combination. Each infusion made him violently ill and forced his hospitalization. He died in March 2002.

Last month, at the federal courthouse in Albany, Mrs. Steubing glared at Mr. Kornak, 53, as he pleaded guilty to fraud, making false statements and criminally negligent homicide in the death of an Air Force veteran, James DiGeorgio. When Mr. Kornak admitted to falsifying the medical data of “subject initials CMS” – Carl M. Steubing – Mrs. Steubing’s face crumpled.

Mr. Kornak, who is scheduled to be sentenced in May, also agreed to cooperate in a widening investigation of the hospital’s cancer research program. From 1999 to 2003, when he worked there, scores of veterans were, at the least, put at risk. But allegations of carelessness, fraud and patient abuse in the hospital’s cancer research program predated Mr. Kornak, and employees say that administrators not only dismissed their concerns, but harassed them for standing up for the veterans.

“Research violations were a way of life at Stratton for 10 years,” said Jeffrey Fudin, a pharmacist at the hospital. “Stratton officials turned a blind eye to unethical cancer research practices and punished those who spoke out against them. The whole Kornak episode could have been prevented.”

According to Mr. Kornak’s lawyer, E. Stewart Jones, there was a “clear systems failure,” permitting a research culture where “rules weren’t followed, protocols weren’t applied and supervision was nonexistent.”

It was also a culture whose descent into criminality forced the Department of Veterans Affairs nationwide to reckon with what an internal memorandum in 2003 described as “systemic weaknesses in the human research protections program, especially in studies funded by industry.”

Excluding simple chart reviews, about 80 percent of the department’s human research is financed by industry. The private sector pumps considerable cash into the system. In Albany, it accounted for $500,000 of the $1.15 million in research funding in 2004.

Mr. Kornak, who declined to be interviewed, does not appear to have derived financial gain from his fraud. The Albany hospital’s research program, however, stood to benefit from the enrollment of patients, pulling in $5,000 from the drug company Aventis for Mr. Steubing’s participation.

Although veterans knew him as “Dr. Kornak,” Mr. Kornak was not licensed to practice medicine. Mrs. Steubing first learned this a year after her husband’s death when she read an article in The Times Union of Albany.

By 1993, Mr. Kornak had obtained and lost medical licenses in several states by forging his credentials and had pleaded guilty in Pennsylvania to felony fraud charges. The Albany hospital hired Mr. Kornak, who did attend some medical school, as a research coordinator, not as a physician. Nonetheless, he performed physical examinations, and his Veterans Affairs business card identified him as an M.D.

James A. Holland, Mr. Kornak’s supervisor, was the real M.D. and the principal oncology researcher. Federal prosecutors said in court papers last year that Dr. Holland, too, was possibly facing criminal charges.

Dr. Holland, who now works at Archbold Memorial Hospital in Thomasville, Ga., declined to comment. Archbold, in a statement, said Georgia’s medical board had investigated Dr. Holland’s actions in Albany and found no evidence of misconduct.

In September, however, the Food and Drug Administration started proceedings to disqualify Dr. Holland from conducting further clinical research because he had “failed to protect” subjects under his care in Albany.

According to the F.D.A., patients’ medical records were altered in at least five experimental drug studies, enabling veterans like Mr. Steubing to be enrolled in studies for which they were either too sick or too healthy to qualify. A patient with coronary disease, for instance, was enrolled in a study that excluded heart patients because of a risk of hemorrhages. A patient with impaired renal function was administered a drug toxic to kidneys that probably contributed to his death, the agency said.

“It kills me to think that the V.A. system deceived us,” said Mrs. Steubing, the director of an upstate school for emotionally troubled children. “You see these youngsters at Walter Reed now and everybody’s raving about the care they get. Well, Carl was one of those kids once, with a Bronze Star, a Purple Heart. And at the end of his life, his treatment was the antithesis of what you see on TV. It was such a betrayal.”

It can be hard to determine whether an experimental treatment is the cause of a cancer patient’s death. Mrs. Steubing will never know if her husband might have survived longer if he had undergone standard chemotherapy treatment or if he might have been spared the suffering he endured after each experimental infusion. The questions will always plague her, she said.

But, as Mr. Kornak’s homicide conviction indicates, the authorities have attributed one death directly to his fraud. In 2001, Mr. DiGeorgio, 71, declined precipitously and died within two weeks of being infused with experimental drugs that he should not have been given.

“My husband trusted and confided in the V.A. in Albany, and he wouldn’t go nowhere else,” Judith DiGeorgio, his widow, said. “It’s a disgrace what they did to him.”

Jon A. Wooditch, a deputy inspector general for Veterans Affairs, said department employees were forbidden to answer questions for this article because of the continuing investigations. Officials from the inspector general’s office have been questioning hospital employees in the last several weeks.

After Mr. Kornak’s guilty plea, the hospital director, Mary-Ellen Piché, circulated a letter to the staff noting “many improvements in research since the events,” among them that “credentials of researchers have been checked and confirmed” and that researchers have undergone ethics training.

Mr. Kornak, as it turns out, was so trained. As a certified clinical research professional, he had passed an examination covering such ethical topics as informed consent and clinical fraud.

Both Mrs. Steubing and Mrs. DiGeorgio have sued Mr. Kornak, Dr. Holland and the Department of Veterans Affairs. Mrs. Steubing’s complaint, in a class-action suit, says that veterans were treated like “guinea pigs.”

Overwhelmed Watchdogs

In the 1990’s, because of a marathon of new drug development, the field of clinical research grew into a multibillion-dollar industry, overwhelming the systems developed to protect human research subjects.

The ethical model for those systems was born in 1947 after German physicians were convicted for performing crippling and deadly medical experiments on concentration camp prisoners. But the Nuremberg Code did not stop unethical research.

Well into the 1970’s, the federal government sponsored human radiation experiments and the Tuskegee experiments, in which black men with syphilis were studied but not treated or told they had the disease.

Outrage over the Tuskegee experiments led to the gradual development of federal regulations governing clinical research. These regulations established the cornerstone protections for human subjects: a voluntary, informed consent process and oversight by an institutional review board, which would evaluate and monitor the scientific validity and ethical standards of studies.

In the 1990’s, however, the surge in drug research strained the institutional review boards and raised new questions about conflicts of interest and government oversight.

Veterans Affairs doctors have done pioneering research on spinal cord injuries and schizophrenia and helped develop the cardiac pacemaker. But like universities and private research companies, the department has grappled with allegations of exploiting its human research subjects.

The veterans department’s situation, though, was singular. Veterans, many unable to afford private health care, are a particularly captive and altruistic pool of subjects, “easy marks,” said Alan Milstein, a lawyer for Mrs. Steubing.

And the department’s huge, taxpayer-financed health care system, despite reports of significant improvements in quality of care, has struggled with issues of mismanagement. These problems include persistent complaints about abuse of power, cronyism and reprisals against whistle-blowers.

Speaking Up, to No Avail

Years before Mr. Kornak arrived at the Albany hospital in 1999, Mr. Fudin, a clinical pharmacist there, started expressing his concerns about the treatment of cancer patients.

Beginning in 1993, Mr. Fudin variously alleged that patients were placed in experimental studies without their consent, that patients who were ineligible for studies were nonetheless enrolled, and that patients were given “alternative therapies” that should have been classified as research. Veterans, he said, may have died as a result.

The former pharmacy manager, Anthony Mariano, shared his subordinate’s concerns.

“Every violation, I hand-delivered packets of information to the chief of research, threw them down on his desk and demanded he do something to stop the research,” Mr. Mariano said.

Instead, Mr. Fudin and Mr. Mariano found themselves under internal investigation. In 1996, Mr. Fudin was accused of patient abuse for refusing to dispense a certain cancer therapy. Mr. Fudin said he thought the therapy amounted to unsafe experimentation on patients. He was cleared of the charge, faced a second charge and again was cleared.

Claiming harassment and reprisal for whistle-blowing, Mr. Fudin filed a complaint with the Office of Special Counsel, a federal agency intended to protect federal employees. In late 1996, Veterans Affairs and Mr. Fudin reached a settlement. The department agreed to sponsor him for a doctorate in pharmacy by paying his tuition ($21,986) and giving him a flexible work schedule.

“It is regretful that these investigations of your clinical practices took place,” a senior Veterans Affairs official wrote to Mr. Fudin.

Still, Mr. Fudin said he was frustrated that his concerns about the cancer research program had not been addressed. His allegations were investigated in the mid-1990’s, but the doctor who conducted the inquiry, Thomas Ferro, said it was cursory and, ultimately, thwarted.

“There is always a hidden agenda either to exonerate or convict in these internal investigations,” said Dr. Ferro, who is now at the Veterans Affairs hospital in Richmond. “In this case it was to exonerate. I was buddies with the doctor I was deputized to investigate.”

Dr. Ferro said he did “a fairly superficial investigation only oriented toward uncovering egregious errors, of which none were found.” He reviewed about 10 patient charts, he said. He found a consent form missing in one and “consent form discrepancies” in others.

Dr. Ferro said he also found “creative science” in the use of “alternative chemotherapeutic regimens.” He said he was convinced that the oncologist was genuinely trying to help patients survive longer. “But,” Dr. Ferro said, “it didn’t strike me as prudent to be using alternative regimens when there was no clear-cut evidence they were helpful and the possibility that they might be harmful.”

Dr. Ferro said he “watered down” his findings in his final report, stating that no major violations were found, but that “minor discrepancies” were. His superiors, however, did not like any mention of problems, and they whited out “minor discrepancies” and other negative phrases, Dr. Ferro said.

They asked Dr. Ferro to initial the deletions, and he protested, but eventually did so, he said, “so as not to be a troublemaker.”

Dr. Ferro said he also recommended strict monitoring of cancer drug studies, and his ideas included having a chemotherapy expert “review the consent forms and review the documentation to make sure the patients were eligible for the studies.”

But the recommendations were shelved, he said. “The solution to the Kornak problem yet to come was in that document,” he said.

Both Mr. Fudin and Mr. Mariano faced additional internal investigations. Mr. Fudin was dismissed in 2001, and an administrative law judge ordered him reinstated in 2002.

Mr. Mariano, meanwhile, was criticizing a cost-saving drug substitution policy involving hypertension medication that he contended was harming patients who suffered from congestive heart failure. In 1999, after he published an article in a federal medical journal questioning the department’s drug policies, he was, at one point, reassigned from the pharmacy to a locked psychiatric ward and given no duties.

Eventually, after a complicated legal process, Mr. Mariano said, he resigned under pressure in 2001, and he now works as a pharmacist for Wal-Mart.

Mr. Fudin and Mr. Mariano served as grand marshals for Albany’s Memorial Day Parade in 2003, selected by local veterans honoring what they described as the men’s courage in blowing the whistle. Some veterans wore T-shirts emblazoned with whistles and, on a rainy May day, blew whistles as they marched.

Convicted, Then Hired

In 1993 in Harrisburg, Pa., Judge William W. Caldwell of United States District Court sentenced Mr. Kornak to a $2,500 fine and three years of probation for forging his credentials to obtain a medical license. Apparently, Mr. Kornak’s history of fraud began with the falsification of a college transcript, and lie followed lie until he lost a medical license in Iowa, was denied one in New Jersey and was arrested in Pennsylvania.

“As we all know, a house built on sand will eventually fall, and a career whose foundation is built on deception likewise has fallen,” Judge Caldwell said. “I think the conviction for this offense is going to make it extremely difficult, if not impossible, for Mr. Kornak to pursue a medical career.”

Six years after Judge Caldwell’s pronouncement, Mr. Kornak answered an advertisement for a research assistant position at the Albany veterans hospital’s research institute.

It was 1999. Dr. William Hrushesky, then the chief oncologist, interviewed Mr. Kornak, according to The Medical Research Law and Policy Report, a trade publication. (Dr. Hrushesky did not respond to inquiries from The New York Times.)

Mr. Kornak told Dr. Hrushesky that he had lost his medical license because he could not document a year of medical school in Poland, according to the journal. Mr. Kornak “gave us a résumé with an M.D. on it and a lot of gaps,” Dr. Hrushesky told the journal. “We decided to give him a chance.”

Dr. Hrushesky also said he assumed that the research institute, a foundation that oversees industry grants for research, checked Mr. Kornak’s credentials before hiring him. (Eventually, Mr. Kornak was hired away from the foundation by the veterans department itself.)

But at that point, the Veterans Affairs system did not require much background or credential checking for health professionals other than for physicians and dentists, and the system did not double-check to make sure that its hospitals actually did the required screening of doctors, according to a General Accounting Office report issued last year.

At the Albany veterans hospital, Dr. Holland inherited Mr. Kornak as a research associate. Mr. Fudin, the pharmacist, and other employees said Dr. Holland was swamped by the cancer patient load. According to an F.D.A. letter to Dr. Holland, he delegated far too much responsibility to unqualified subordinates in numerous drug studies.

Mr. Steubing was not a regular patient of the Albany hospital and, because he had private insurance, he was not a typical Veterans Affairs patient. He sometimes went to the veterans’ hospital in Castle Point, N.Y., for checkups, but he used private physicians for important health issues.

In early 2001, when Mr. Steubing’s gastroesophageal cancer was diagnosed, doctors at the Memorial Sloan-Kettering Cancer Center in Manhattan recommended a widely used two-drug chemotherapy regimen, which was available at Castle Point, closer to their home in Hopewell Junction.

At Castle Point, an oncologist suggested that Mr. Steubing see if he qualified for an experimental drug program, which added a third drug, Taxotere, to the mix. The study, sponsored by the drug company Aventis, involved both Sloan-Kettering and Veterans Affairs in Albany. Sloan-Kettering had a waiting period, Mrs. Steubing said she was told. Albany did not.

The Steubings met with Mr. Kornak.

“Kornak was your classic good-time Charlie,” Mrs. Steubing said. “Carl thought he could pick out a phony a mile away, but he really loved this guy.”

Mr. Kornak never gave them any indication that Mr. Steubing did not qualify for the study, Mrs. Steubing said. Instead, he encouraged Mr. Steubing to continue with the regimen even though it was devastating him.

“Kornak would say: ‘You’re going to beat this. The odds are in your favor,’ ” Mrs. Steubing said. “Little did we know that what they were doing to Carl was probably hastening his death rather than extending his life.”

Routine Visit Leads to an Inquiry

In December 2001, a clinical research associate for Ilex Oncology made a routine visit to the Albany veterans’ hospital, where Ilex was sponsoring a bladder cancer study.

Ilex, a cancer drug company, was offering the Albany research program $2,500 for each study subject. Such payments are a standard practice, and many researchers say that they barely cover the cost of conducting the studies. Critics of drug-testing practices, however, consider the payments a threat to scientific integrity.

Ilex’s research associate discovered some paperwork that raised suspicions, according to Caren Arnstein, a spokeswoman for the Genzyme Corporation, which bought Ilex at the end of last year.

“Things about the dates didn’t look right,” Ms. Arnstein said. “If the results of a pathology report for a biopsy are dated prior to the biopsy being taken – something seemed off.”

The discrepancies led to an audit by Ilex. In the spring of 2002, the Albany hospital began an internal review of the cancer research program, eventually referring the matter to the inspector general, according to The Times Union.

Ilex shut down the Albany study and alerted the F.D.A. The agency had also received another complaint, an F.D.A. official said.

In November 2002, the F.D.A. sent an investigative team to Albany. On average, it takes about a week to investigate a complaint. That team spent more than 50 days at the hospital. It studied the files of more than 50 research subjects and found problems in almost every one, according to its investigation report.

In January 2003, Mr. Kornak and Dr. Holland were dismissed. Mrs. Steubing got an unnerving call from a hospital official, telling her that her husband’s care might have been “compromised.”

“I said, ‘Well, Dr. Kornak and Dr. Holland were so wonderful to us,’ ” Mrs. Steubing said. “There was dead silence on the line and I thought, ‘Oh, it’s them.’ ”

Shaking Up the System, Twice

The year that the Albany veterans research program hired Mr. Kornak, 1999, was supposed to be a year of reckoning for the $1.2 billion research program at Veterans Affairs.

Federal regulators shook the system by suspending all human research at the West Los Angeles Veteran Affairs Medical Center, saying that it had been lax for years in obtaining informed consent and overseeing research.

News media reports about abuses of human subjects in West Los Angeles unleashed the fury of Congressional watchdogs, who asked the General Accounting Office to assess the safeguards for veterans who serve as research subjects. The office examined eight Veterans Affairs medical centers and reported “a disturbing pattern of noncompliance with regulations for the protection of human subjects.”

Dr. Stephan Fihn, the acting director of research and development for Veterans Affairs, said in an interview: “Historically, we relied on the integrity of investigators. In the vast majority of cases, that worked. We did discover, well, the tendency is to say, bad apples. There were some pretty egregious violations.

“What Congress basically said was that the V.A. has to take a very active role. What was lacking in human subjects protection was a strong oversight and enforcement effort.”

But the department did not change overnight, as the General Accounting Office said in a follow-up report four years later. It apparently needed a second shock to its system, and that came in 2003 when the problems in Albany – and the accidental fatal overdosing of a Veterans Affairs research subject in Detroit – came to light.

A new director of research for the department, Dr. Nelda Wray, ordered a nationwide review of research at Veterans Affairs medical centers and halted clinical research in Fargo, N.D., because the institutional review board there had all but ceased to function. She also ordered credential checks on researchers and ethics training for them.

By early 2004, the department’s inspector general had accused Dr. Wray herself of ethical problems and improprieties, including the mishandling of funds provided to Veterans Affairs by drug companies. Her lawyers called the investigation “an easy and convenient tool to stop sorely needed reforms.” She eventually left the department.

But there does appear to have been a sea change in the department’s approach toward protecting the subjects of human research. An external nonprofit agency, the National Committee for Quality Assurance, was hired in 2001 to accredit the agency’s programs to protect human subjects. The accreditation process, which requires medical centers to open up their research programs to full scrutiny, is rigorous.

At first, the committee met hostility.

“We just showed up and started telling them what was wrong, and it was way too abrupt,” said Brian Shilling, a spokesman for the committee. “But there’s been a lot of education and culture change in the V.A. since then.”

Just under a third of the veterans department’s 118 research centers have been accredited so far. Some centers did not pass their initial reviews, and research was curtailed until they showed improvement. One medical center, in Northampton, Mass., failed to earn accreditation.

Albany has not yet applied.

Gay vets’ benefits at risk?

As many as a million gay and lesbian veterans depend on the U.S. Department of Veterans Affairs for health care—including many who can’t get HIV/AIDS care anywhere else. It’s reason enough for GLBT activists to keep an eye on the Bush administration’s coming cutbacks

On January 6 veterans across the country were shocked to learn that Republican congressman Chris Smith of New Jersey, the chair of the House Veterans Affairs Committee, had been ousted from his position in favor of the much more right-wing Republican Steve Buyer of Indiana. 

Smith was widely regarded as a staunch defender of veterans’ benefits, and it is widely believed that the GOP removed him in order to replace him with someone who would be much more amenable than Smith had been to implementing severe cutbacks at the U.S. Department of Veterans Affairs. 

Does this matter at all to the GLBT community? You wouldn’t think so, from the reaction of GLBT rights organizations, which was silence. In fact, you’d be hard pressed to find a press release or public statement from any GLBT organization on any matter related to VA. I cannot find a single GLBT lobbyist who has contacts on either of the Veterans Affairs Committees, nor a single HIV/AIDS organization that will so much as provide a link from its Web site to VA’s HIV/AIDS information page. 

But VA does matter to us a great deal. The Urban Institute estimates that there are well over a million GLBT veterans in the United States. We don’t know how many of them depend upon VA for health care, but we do know that VA is the nation’s single largest health care provider of HIV/AIDS-related services, with over 20,000 HIV-positive vets in the VA system, and that many other, primarily low-income GLBT vets depend on VA for treatment of other chronic conditions. 

Many of those veterans may not be in the VA health care system for much longer. 

In 1996, Congress changed VA’s eligibility criteria, allowing most honorably discharged veterans with income under about $30,000 a year to receive care at VA medical centers, regardless of whether they are disabled or ever served in a war zone. Elderly veterans without prescription coverage quickly learned that they could receive prescription drugs from VA and began crowding into VA hospitals, tripling VA’s patient caseload in just a few short years. 

Rather than respond by either increasing the VA’s funding or, better yet, solving the national prescription drug crisis, the Bush administration, with the assistance of people like Buyer, is expected to propose a return to the pre-1996 eligibility criteria, possibly in the next term. The effect would be to throw several million veterans, many of whom are uninsured, out on the street. A gay friend of mine who is receiving treatment from VA for his stage 4 cancer says, if that happens, “I guess I’ll just go out on the White House lawn and die there in protest.” And forget about adding HIV to the VA’s list of “catastrophic disabilities,” which entitles veterans to health care regardless of their income level, a proposal that will almost certainly fall by the wayside now. 

What can you do about this? 

You can start by getting involved with a veterans’ organization—if not my own organization, American Veterans for Equal Rights, then one of the mainstream organizations. Don’t assume that these groups will be hostile or homophobic. Vietnam Veterans of America, for example, sent its head lobbyist to speak at AVER’s recent convention. Most of these organizations, like The American Legion, Veterans of Foreign Wars, and AMVETS, are hungry for new members, especially younger veterans. Getting involved with them is a great way to build bridges between the GLBT and straight communities, and there are few nobler causes than helping out our nation’s veterans in their hour of need. 

Lara Ballard is a regional vice president of American Veterans for Equal Rights, a nationwide grassroots network of GLBT veterans and allies. She can be reached at ballardla@aver.us

Wounded in Action

The first symptom was sleeplessness. It was July 2003 and Lance Corporal David McGough of the Royal Army Medical Corps was just back from a five-month tour of duty in Basra, Iraq. Lots of the lads from his unit had trouble settling back to a normal routine at first, but most were OK within a fortnight or so. David, however, did not sleep for an entire month.

“My body just wouldn’t switch off,” he tells me, fidgeting with his hands. “All the time this tension was building, this incredibly tense restlessness. I was going for weeks without any sleep at all and then collapsing, sleeping for maybe six hours, and then starting all over again.” At night, on leave, he walked around his small maisonette in a suburb of Preston, Lancashire, folding and re-folding his clothes, checking and double-checking the locks, looking over his shoulder repeatedly for imagined intruders.

McGough was vomiting every day, often bloodily. The odour of cooking or burned meat made him sick, though “the worst thing is the smell of public toilets”. “That brings the PoW camps back. The stench of those places was horrendous.”

Mostly it was the insomnia that started to drive him mad, that made him crash his car and almost beat his then-fiancee, that both masked and exacerbated his chronic underlying depression. The army doctor at the camp in Preston prescribed him Prozac and more or less told him to pull himself together. When Prozac failed to work, McGough was given a stronger antidepressant, citalopram, “but no sleeping tablets, and by then – Christmas – I wasn’t really sleeping at all”.

McGough’s two attempts at suicide, both at Christmas in 2003, were more cries for help than committed bids to kill himself. On the first occasion he held a knife across his throat until his sister begged him to put it down, and on the second he put a 9mm pistol to his head but did not pull the trigger fully. Horrified by what was happening, McGough’s father, a civil servant based in Northern Ireland, called Dr Alun Jones, a civilian psychiatrist who specialises in diagnosing and treating psychological problems in servicemen and women. “It was immediately clear,” says Jones, “that McGough was suffering a severe case of post-traumatic stress disorder.”

So far, PTSD experts have seen a mere handful of British sufferers from this latest war in Iraq – but as the violence goes on, the trickle is expected to become a flood. Late last year, the independent inquiry into Gulf war illnesses chaired by Lord Lloyd of Berwick came to the conclusion that there was “every reason” to accept the existence of a Gulf war syndrome, and that post-traumatic stress was one of several contributing factors. Though the Ministry of Defence does not publish statistical predictions, military psychiatrists in America have been warned to expect psychiatric disorder to occur in a remarkable 20{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of servicemen and women returning from Iraq.

“What we’ve got now is a situation starting to approximate to Northern Ireland or Bosnia, to civil insurrection rather than a straight shooting war,” says Jones, who runs PTSD clinics around the country and at a residential centre in north Wales.”In those kinds of circumstances, where you’re experiencing hatred and violence from an unpredictable civilian population, we tend to get a lot of very disturbed and damaged soldiers.” In the field of trauma studies, this atmosphere of constant and random danger is known by the shorthand “no safe place”.

Other surveys suggest that roughly half the servicemen who suffer psychiatric illness as a result of traumatic events do not seek medical help, or do so years later, when the psychological afterburn has irreparably damaged marriages, careers and mental wellbeing. “And there’s still a stigma attached,” says Leigh Skelton, director of clinical services at Combat Stress, the ex-services mental welfare charity. “PTSD is seen as a career-stopper within the army. Generally, the first line of action servicemen and women take is to bottle it up. Then they’ll self-medicate, usually with alcohol, sometimes with other substances. Cries for help often come from relatives rather than from the affected person.”

Symptoms range from insomnia, nausea and extreme fatigue to the classic “flashback”; aggression, feelings of alienation and irrational anger. Sometimes the disorder centres on one particular memory. A 30-year-old female ambulance driver in the Territorial Army, for example, constantly replays the moment her vehicle was blown up last year by a hand-made bomb tied to a lamp-post in Basra. One marine in his early 20s now suffering chronic PTSD remembers “the fear in the eyes of an Iraqi soldier in the window” of a building mortared by the British; and seeing that fear again when British soldiers mistakenly opened fire on a civilian vehicle.

McGough, however, identified no single trigger. Skinny and pale, when I met him in late November he was a shadow of the strong young man he was pre-Iraq – the high-flyer who studied psychology at Queen’s College, Belfast, who loved to sky-dive and socialise, who was promoted within a year of joining the RAMC. For him, the pressure began the moment he and his medical unit moved into Iraq, at 2.30am on the first night of the war, four hours after the Americans began their aerial bombardment of Baghdad.

McGough was 21 years old and effectively in charge of 80 rookie soldiers fresh out of training, most of them still teenagers. As medics, they travelled in canvas-roofed trucks and were not equipped with body armour. “There was gunfire everywhere. Some of them were literally crapping themselves in the back of those trucks.” That first night, there wasn’t even time to pitch camp. “The worst casualty I saw was an Iraqi guy hit about 13 times, big chunks of his stomach, face and legs just gone. We intubated him and opened him up by the side of a truck. You do it on autopilot at the time because your training kicks in. It’s only afterwards you start to think about what you’ve seen and done.”

The mobile field unit, the first line of medical services, was initially established just south of Basra, but was twice relocated to escape attack. Its job was to mop up trauma cases, stabilise them and send them to field hospitals nearer the southern border. According to McGough, the medical unit received up to 1,000 wounded Iraqis during his five-and-a-half-month tour of duty, of whom perhaps 60{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} died and were buried in mass graves.

A large proportion of the medics’ work, however, took place in the PoW camps set up on each site. “Usually we had about 150 prisoners coming in a day,” says McGough, “both soldiers and civilians who’d been picked up with guns. Some had clearly been tortured by the Iraqi regime. There was one man who had thick black stuff, like goo, coming out of his penis, and said he’d been injected with something when he was a prisoner before. Others had quite infected lash wounds on their backs, or broken jaw bones.” The unit also saw a number of raped women, who were treated and counselled by a female army gynaecologist.

Seemingly futile or absurd situations are known to compound wartime trauma. The unit’s first location at Basra was regularly attacked by Iraqis defending a nearby ammunition dump from a maze-like system of trenches. “There was no adherence to any kind of convention on their part. Sometimes it was ridiculous. Every time we hit and wounded someone, a white flag would go up on their side and the others would bring the man we’d wounded over to the base for treatment. Then they’d go back up and start shooting at us again.”

Most harrowing of all was the discovery of the corpse of a 12-year-old girl who’d been hanged in a backstreet alley in Basra. McGough was sent to confirm the death and recognised her as the child to whom he and his comrades had chatted the week before. “We heard later that she was probably hanged by the crowd because she’d been talking to our crew … That was one of the worst things. You expect to see some nasty stuff, but seeing a little girl hanging in the street because she once spoke to you … ”

PTSD has been a recognised injury of war for more than 30 years, yet treatment in Britain is still very patchy. It took complete break-down (“my girlfriend found me one night huddled on the floor, shaking and crying”) and several emergency trips to hospital in Preston before McGough was finally prescribed sleeping tablets. While a member of the British army, he was unable to access the civilian care system – and had been informed of a decision to discharge him without a pension.

“The army is not a branch of the social services,” says Jones, “but I do think there is a certain duty of care, knowing what we now know about the effects of trauma. It would be reasonable to expect the army to check these lads over for psychological injury when they come back from combat, but in fact there is no obligation whatsoever to do this.”

“No one rings or visits in the mornings because I’m just a horrible, nasty person before the drugs have kicked in,” says McGough. He was increasingly convinced that his physical symptoms – the vomiting and chronic weight loss – are related to anthrax injections and to the Naps tablets taken to counter the potential use of enemy nerve agents. On bad days he does not get out of bed at all.

“I loved being in the army,” he says. “It was supposed to be my long-term career, and I was prepared to give everything to it … I just wish I could shake this and get on with my life again.”

Troops unable to be treated for skin disease in Iraq will be seen by doctors in U.S.

ARLINGTON, Virginia — U.S.-based military doctors are bracing for a wave of servicemembers returning from Iraq this spring whose treatment for a skin disease has been delayed by the dangerous security situation there.

The soldiers who may be infected with cutaneous leishmaniasis are mostly from the 1st Brigade of the 25th Infantry Division, the Army’s “Stryker Brigade,” according to Dr. Alan McGill, infectious disease specialist at Walter Reed Army Institute of Research in Silver Spring, Md.

“We’ve heard rumors of a couple hundred cases in the Stryker Brigade,” McGill said Friday.

But travel in Iraq is so perilous for U.S. troops that health care staff there are choosing to let suspected cases of the disease go, rather than risk a trip to the large medical facilities for diagnosis, said McGill, the U.S. military’s leading leishmaniasis expert.

“Doctors in the field are making some hard choices, because any movement in Iraq places your life in jeopardy,” he said.

McGill said he agrees with that decision, because the sores caused by cutaneous leishmaniasis eventually go away without treatment.

“If I were over there, I wouldn’t take the risk of sending [a soldier] to [a large medical facility] to treat a skin lesion that’s going to get better anyway,” McGill said.

Although treatment for some may have been delayed, troops whose skin lesions are serious will be accommodated once their deployments are over, McGill promised.

“The security situation may have prevented a timely evaluation by stateside standards, but as soon as these guys get home, we are going to take care of them,” McGill said.

Leishmaniasis takes hold when infected sand flies bite humans who sleep on the ground or work in very dirty, sandy environments.

Human cases of leishmaniasis mostly fall into one of two categories: cutaneous, which causes skin lesions that vary from the size of a pencil head to larger than the bottom of a soda can; and visceral, a far more serious variation which leaves no external marks, instead attacking the internal organs.

Untreated visceral leishmaniasis can be fatal, according to the Centers for Disease Control and Prevention in Atlanta.

But sores from cutaneous leishmaniasis “heal on their own, [although] this can take months or even years … and leave ugly scars,” according to CDC spokesman Llelwyn Grant.

U.S. military doctors diagnosed about 750 cases of leishmaniasis among troops who participated in the first rotations of Operations Iraqi Freedom or Enduring Freedom in Afghanistan, McGill said.

Of those, only four cases of visceral leishmaniasis have been diagnosed, two from Iraq, and two from Afghanistan, he said.

Military physicians are expecting fewer cases among troops deployed in the second rotations of OIF and OEF, because most troops now stay in screened, air-conditioned facilities — one of the CDC’s primary recommendations for avoiding infection.

To date, WRAIR has received confirmed reports of about 20 cases of leishmaniasis from OIF2 and OEF2 troops, all of which are cutaneous, McGill said.

Nevertheless, “we think that we’ll see a delayed bubble of cases in March and April,” when second rotation troops begin coming home in large numbers, McGill said. “If we see 100 cases that need [treatment], I would not be surprised.”

Dear America,

I am a soldier, and I served in Iraq.

I spent the last year riding in an unarmored humvee with no doors, open to the whims of the enemy and the splashes of sewage from the wheels. I have cursed the generals in their plush palaces and air conditioned SUV’s. I have shivered with Dengue Fever, sweated in the 130 degree heat, and gotten violently ill an average of twice a week courtesy of the mess hall. I have cursed when an RPG was fired at me, only to laugh when it failed to explode because Hadji forgot to pull the pin. I am all too familiar with the buzz a bullet makes as it passes.

If you are an Iraqi, I will shake your hand, kiss the side of your face, drink your tea, share a meal together, and play with your children. I will count you as a friend. I do not care if you are Sunni, Shia, or Christian. I will fix your sewer. I will make sure you have food and clean water. I will give you the freedom to speak your mind without the threat of summary execution. I will shake my head in frustration when you ask, “What have you done for me lately?” I will not hesitate to put you down for good when I see you planting an improvised bomb on the sidewalk.

I will never be the same, and I want to scrub my mind with steel wool to remove the memories. I have watched the light fade from the eyes of another human being and known that I could not save him. I have seen animals carrying body parts. I have been told the words that cut directly to the center of an officer’s heart: “Sergeant G’s been hit, and it’s bad.” I have had to choose whether to kill a teenager for pointing a weapon at me. I have pulled the trigger when he turned his weapon toward one of my soldiers. I have drifted off to a fitful sleep with the smell of dead humans on my uniform.

The media will try to jolt you with narratives and images of increasing violence. In reply, pundits and talking heads will trumpet our successes, progress, and the enemy corpse count. Does it matter which side is right? Not really. The only thing that matters is that, right now, over one hundred and thirty thousand men and women in our armed forces are sweating, bleeding, and dying in the desert. They deserve the attention and respect that they have earned with their courage and purchased with their lives.

Jason N. Thelen

Dallas, Texas

Jason Thelen served as a Captain in the US Army Reserve during Operation Iraqi Freedom. This is the first in a series of columns he will be writing for Veterans for Common Sense. He can be reached at jthelen294@yahoo.com

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Two live grenades found in luggage of soldier returning from Iraq

ATLANTA (AP) Two live hand grenades were found in the luggage of a soldier returning from Iraq on Thursday, halting operations at the international terminal of Atlanta’s airport for about a half-hour, a spokeswoman said.

The soldier was aware of the grenades and tried to alert the Transportation Security Agency, “but it was too late. The bags were already being screened,” spokeswoman Felicia Browder said.

She said there was no evacuation of the terminal, but people were kept back a safe distance until a bomb unit removed the grenades.

Passengers on a handful of international flights were not able to leave their planes for more than a half-hour during the incident, Browder said.

The soldier, who was not identified, was released to the military, she said.